Rowe on Peacock and Peterson, 'A Deeper Sickness: Journal of America in the Pandemic Year'

Margaret Peacock, Erik L. Peterson. A Deeper Sickness: Journal of America in the Pandemic Year. Boston: Beacon Press, 2022. 288 pp. $28.95 (cloth), ISBN 978-0-8070-4029-4

Reviewed by Robyn Rowe (Hunter College CUNY)
Published on H-Sci-Med-Tech (June, 2023)
Commissioned by Penelope K. Hardy (University of Wisconsin-La Crosse)

Printable Version:

Historians Margaret Peacock and Erik L. Peterson’s new book examines the social, economic, and political factors that shaped the United States’ initial experiences of the COVID-19 pandemic. Evoking Daniel Defoe’s Journal of the Plague Year (1722), the authors give us a cowritten journal, whose entries (from January 2020 to January 2021) contextualize the unfolding pandemic, situating it within a broader social history of inequality and racism in the United States and bringing to bear their combined expertise in media and propaganda studies (Peacock) and the history of medicine, science, race, and eugenics (Peterson). Along the way, they recount the powerful rise of the Black Lives Matter movement and the presidential election, rounded out by a short epilogue on the January 6, 2021, attack on the Capitol. The book provides an outstanding example of public history. While it is written for a nonacademic audience, it will also be useful for scholars interested in the history and sociology of health and medicine, US history and politics, and the study of racism and inequality.

The book begins with a brief explanation of the authors’ central argument, the background of the project, and their methods. Peacock and Peterson tell us that in 2020, the US witnessed “four pandemics—disease, disinformation, poverty, and violence”—caused by “entrenched racial hierarchies,” a political economic system that enriches a few, and a consumer society with historical amnesia, easily misled by disinformation (pp. ix, xii). To tell their story of the pandemic, they began accumulating “primary sources” as early as the first reports of the new coronavirus, initially in isolation, then in collaboration.

Journal entries begin in early 2020 with the authors closely following reports of the new coronavirus. Describing the contradictory information in the media and comparing representations of the virus from journalists, disease trackers, and policymakers, they capture the uncertainties of the time. Their entries remind us of just how quickly the new coronavirus and illness were racialized and how little concern Western nations showed while the crisis remained in China. Once it spread to Europe and the United States, much more attention was given to the disease, with much of the media coverage taking a racist tone, blaming China and Chinese cultural practices for the virus’s emergence. Here, the authors provide useful historical context, recalling that Western “Sinophobia” has manifested itself in the identification of illnesses with East Asia for centuries, usually without logic or evidence, and that this pattern has served to justify restrictive immigration policies as well as colonial projects in the United States and elsewhere. In this context, Donald Trump’s travel bans to and from China were merely another instance of anti-Chinese policies framed as public health measures. Quick to name the virus “Chinese” (even after months of admiring the authoritarian Chinese leader Xi Jinping), Trump handily identified a scapegoat that resonated far beyond his white nationalist base, fueling anti-Asian violence and conspiracy theories of COVID’s origins.

A second theme developed in the first months of the year is the failures of America’s marketized health system. Peacock and Peterson see no evidence of preparation for a pandemic and paint a picture of a country with little public health infrastructure and no coordination between federal, state, and local governments. As early as January, the authors see that “creating a vaccine will be the only real solution” and note that Johnson & Johnson had already begun to develop one (p. 10). Though not addressed by the authors, this highlights how definitively public health strategies of collective prevention have been biomedicalized. Instead, believing that the US had “dodged a bullet this time,” the authors examine how poorly America’s for-profit medical system would cope if in fact there was an outbreak (p. 17). They suggest with chilling prescience the devastating death tolls in nursing homes, pointing out that the vast majority had been bought by private equity firms that stripped them of staff and raised fees. We now know that death rates were higher in homes with higher numbers of Black residents and caregivers.[1] The details the authors uncover about how poorly the US was prepared for a pandemic before it began highlight issues to investigate further, such as the tensions between the “securitization” of public health and neoliberal financialization and decades of austerity, to understand the making of this pandemic and potentially the next.[2]

Once COVID hits the United States, Peacock and Peterson track the mounting catastrophe through data and detailed anecdotes, bearing witness to the national trauma. Journal entries discuss the politics of the pandemic, showing how shut-downs, masking, and online teaching became intensely contentious issues both in their own community and at the state and national levels. The authors are especially concerned with disinformation about cures and prophylactics that they identify with Fox News, Trump, and other right-wing voices. Peacock and Peterson do valuable work debunking dangerous myths about the disease, despite a somewhat surprising and troubling tendency toward uncritical valorization of and faith in Western science and biomedicine, implicitly identified with truth, progress, and social justice. Their account is unquestionably useful for recording the development of federal legislation to manage the pandemic and reminding readers how far policymakers were willing to go in expanding social protections in an emergency. When Congress passes the CARES Act in late March, temporarily expanding unemployment benefits, giving states new funds for health and social protection programs, and sending direct payments to all adults with additions for each child, the authors argue that much more is needed, recalling the brief surge in support for comprehensive family policies.

The book’s most important passages are those scrutinizing America’s racialized inequalities and their amplification and exacerbation in the pandemic. By April, information collected on positive cases, hospitalizations, and deaths was beginning to include people’s race, ethnicity, and location, in addition to gender and age. The data was immensely important for confirming what many on the ground already understood and social scientists expected: that Black and Latinx Americans were suffering and dying from the disease at much higher rates than white Americans. As Peacock and Peterson point out, historians of epidemics have long known that diseases do in fact discriminate by race. Drawing on then-emerging data, they remind us that over two-thirds of the people dying from COVID in such cities as Detroit, New Orleans, and Chicago were African American, though this community represented only around a third of these cities' populations (p. 64). Most important, the authors emphasize that such inequality of life and death results from systemic racism. One mechanism by which this occurs, they explain, is through persistent, long-term occupational segregation. Channeled into jobs in service and care industries, for example, often low waged, precarious, and unhealthy, racialized minorities became overrepresented among “essential workers,” forced to remain on the “frontline,” unable to “shelter” at home without losing income. Peacock and Peterson later remind us that Black Americans were also hit harder by pandemic unemployment, another leading cause of ill health, even while companies like Amazon were making record profits, further enriching a handful of mainly white male elites. Elsewhere they draw direct connections between slavery and the high death rates of African Americans in Lowndes County, Alabama. When the pandemic struck, the United Nations had recently documented “extreme poverty” in the location, “unseen in the ‘first world’” (p. 121). The authors use maps to show with vivid clarity a nearly perfect match between the counties with the highest slave populations in 1860 and the highest rates of COVID in 2020. Although the authors could have gone much further in their examination of racism and economic inequality as social determinants of health—a phrase that is surprisingly absent from their account—using readily available data, the value of the work they do to explain this to a broad audience cannot be overstated.

The authors make another major contribution to the COVID literature by placing the murder of George Floyd and the historic Black Lives Matter (BLM) mobilization that followed it within the context of the pandemic. A highlight is their autoethnographic account of a BLM march in their “small city in the Deep South” (p. 126). The city is deeply divided; there is jeering from passing trucks while police officers line the sidewalks. Most interestingly, the authors express their own uneasiness in their position, wondering if, as white persons, they are supposed to join in all the chants and, finally, questioning whether their activism mattered at all. This is, unfortunately, the only point where the authors address, even indirectly, whiteness, a subject sorely missing given the centrality of racialization and racism to their story. This is also a point where interviews of participants would have also enriched the account. As historians know, silences tell their own story, here exposing how much work remains in fully integrating and applying anti-racist methods.

As the presidential election of the fall approaches, Peacock and Peterson examine pathologies of American political culture. Throughout the year, they record their frustration with the then president Trump’s false claims and leadership failures. Using their expertise in media and propaganda, they scrutinize right-wing disinformation campaigns and Trump’s communication strategies, which rallied his far-right base and propagated myths and conspiracy theories surrounding COVID. During the election, the authors witness the effects of voter restriction laws, in particular poll site closures, 20 percent of which occurred nationwide during the Trump administration alone. Most closures were in lower income neighborhoods or those with high proportions of Black and Hispanic citizens, as we learn is the case in Alabama, where the authors experience the effects directly. At their polling location, a courthouse, four-fifths of voters were African American, and they waited to vote for hours in the hot sun before being crowded into the courthouse, social distancing thrown to the wind.

At the end of the year, the authors reflect on the role of history in shaping the present and future of the US. They tell us that “real history” is the route to a better future: “our honest acknowledgement of that history is the only thing that might begin to save us, if we can just reckon with it” (p. 212). With this journal, Peacock and Peterson clearly show us one concrete example of the work involved. They seem to evoke the idea of a truth and reconciliation process, discussed in an earlier entry. In countries where such commissions have been used to work through and move past a violent and traumatic experience, evidence suggests that history telling can play a key role in building a different future. Yet it is not enough if the goal is genuine racial equality and a reduction of vast economic inequalities. For such structural change, much more is necessary, including reparations. The authors might have used this opportunity to explore what it would take to make a more fundamental change to address the country’s “deeper sickness.” This would involve attending to the voices of BLM activists and anti-racist writers and scholars, telling of their experiences, demands, and objectives, and, most important, explaining the power of collective action. In addition, this would have been a place to evaluate policies and practices the authors advocate in earlier entries, including the development of public health infrastructure, national health insurance, police and criminal justice reform, universal childcare, paid leave, and a basic income—social and economic policies that enjoyed a moment of popularity during the pandemic and that Americans should be reminded of.

Overall, A Deeper Sickness provides a richly detailed account of the first pandemic year. Through their journal entries and the online archive they created, Peacock and Peterson help us to understand how COVID-19 was constructed and experienced in relation to social, economic, and political forces and how it exposed and amplified America’s deeply embedded racism and inequalities. To overcome these deep pathologies, the authors call for much greater engagement with and awareness of our history in order to move forward, and their work contributes to this process in developing public history. Its accessible language and format and its use of personal anecdotes alongside brief lessons to contextualize events make it a useful text for undergraduates and for a general audience. These are great strengths, and the book will play a lasting role in helping us remember the deeper lessons of the pandemic.


[1]. See, for example, Jasmine L. Travers et al. “Assessment of Coronavirus Disease 2019 Infection and Mortality Rates among Nursing Homes with Different Proportions of Black Residents,” Journal of the American Medical Directors Association 22, no. 4 (2021): 893-898.e2.

[2]. Recent writing on health security includes Colin McInnes, “The Many Meanings of Health Security,” in Routledge Handbook of Global Health Security, ed. Simon Rushton and Jeremy Youde (London: Routledge, 2015), 5-17; and Gwen D’Arcangelis, "Reframing the ‘Securitization of Public Health’: A Critical Race Perspective on Post-9/11 Bioterrorism Preparedness in the US," Critical Public Health 27, no. 2 (2017): 275-84.

Citation: Robyn Rowe. Review of Peacock, Margaret; Peterson, Erik L., A Deeper Sickness: Journal of America in the Pandemic Year. H-Sci-Med-Tech, H-Net Reviews. June, 2023.

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